| NPI | 1275976805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2018018431) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME128145) |
| Enumeration Date | 2013-04-13 |
| Last Update Date | 2020-02-13 |